Prophylaxis with low-dose low-molecular-weight heparin during pregnancy and postpartum: Is it effective?

J. E. Roeters Van Lennep*, E. Meijer, F. J.C.M. Klumper, J. M. Middeldorp, K. W.M. Bloemenkamp, S. Middeldorp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

56 Citations (Scopus)


Background: The optimal approach for venous thrombosis (VTE) prophylaxis during pregnancy and postpartum in women with an increased risk of VTE is not established. Objectives: To evaluate the effectiveness, represented as the incidence of pregnancy-related VTE, and safety, represented as incidence of postpartum hemorrhage (PPH), of a protocol recommending prophylaxis with low-dose low-molecular-weight heparin (LMWH) in women at intermediate to high risk of VTE. Patients/methods: In this retrospective cohort study, we analyzed 34 women (44 pregnancies) with intermediate risk of VTE who received low-dose LMWH for 6weeks postpartum and 57 women (82 pregnancies) with high risk of VTE who received low-dose LMWH during pregnancy and for 6weeks postpartum. Pregnancy-related VTE was defined as VTE during pregnancy or ≤3months postpartum. PPH was defined as blood loss >500mL and severe PPH as blood loss>1000mL. Results: The incidence of pregnancy-related VTE was 5.5% (95% CI, 2.4-12.3) despite prophylaxis with low-dose LMWH. All events occurred in women at high risk, with a postpartum incidence of 7.0% (95% CI, 2.9-16.7) and antepartum incidence of 1.8% (95% CI, 0.4-9.2). The risk of PPH was 21.6% (95% CI, 14.3-31.3) and severe PPH 9.1% (95% CI, 4.7-16.9), which was not different in women who started LMWH postpartum and those who used LMWH during pregnancy. Conclusions: Although prophylaxis with low-dose LMWH during pregnancy and postpartum proved to be safe, the risk of pregnancy-related VTE is considerable in women with a high risk of VTE. VTE prophylaxis with low-dose LMWH may not be sufficiently effective in these women.

Original languageEnglish
Pages (from-to)473-480
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Issue number3
Publication statusPublished - 1 Mar 2011
Externally publishedYes


  • Low-molecular-weight heparin
  • Postpartum hemorrhage
  • Pregnancy
  • Pulmonary embolism
  • Venous thrombosis


Dive into the research topics of 'Prophylaxis with low-dose low-molecular-weight heparin during pregnancy and postpartum: Is it effective?'. Together they form a unique fingerprint.

Cite this